Smokeless Tobacco: Health Effects

Smokeless tobacco is associated with many health problems. Using smokeless tobacco:

• Can lead to nicotine addiction^1,2
• Causes cancer of the mouth, esophagus (the passage that connects the throat to the stomach), and pancreas (a gland that helps with digestion and maintaining proper blood sugar levels)^1,2
• Is associated with diseases of the mouth^1,3
• Can increase risks for early delivery and stillbirth when used during pregnancy²
• Can cause nicotine poisoning in children⁴
• May increase the risk for death from heart disease and stroke^1,3

Addiction to Smokeless Tobacco

• Smokeless tobacco contains nicotine, which is highly addictive.^1,2
• Because young people who use smokeless tobacco can become addicted to nicotine, they may be more likely to also become cigarette smokers.⁵

Smokeless Tobacco and Cancer

Smokeless Tobacco and Oral Disease

• Smokeless tobacco can cause white or gray patches inside the mouth (leukoplakia) that can lead to cancer.¹
• Smokeless tobacco can cause gum disease, tooth decay, and tooth loss.^1,3

Reproductive and Developmental Risks

• Using smokeless tobacco during pregnancy can increase the risk for early delivery and stillbirth.²
• Nicotine in smokeless tobacco products that are used during pregnancy can affect how a baby’s brain develops before birth.^2,7

Other Risks

• Using smokeless tobacco increases the risk for death from heart disease and stroke.^1,3
• Smokeless tobacco can cause nicotine poisoning in children.⁴
• Additional research is needed to examine long-term effects of newer smokeless tobacco products, such as dissolvables and U.S. snus.

References

1. World Health Organization. IARC Monographs on the Evaluation of Carcinogenic Risks to Humans. Volume 89: Smokeless Tobacco and Some Tobacco-Specific N-Nitrosamines.[PDF–3.18 MB] Lyon (France): World Health Organization, International Agency for Research on Cancer, 2007 [accessed 2014 Oct 31].
2. U.S. Department of Health and Human Services.The Health Consequences of Smoking—50 Years of Progress: A Report of the Surgeon General. Atlanta: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health, 2014 [accessed 2014 Oct 31].
3. Piano MR, Benowitz NL, Fitzgerald GA, Corbridge S, Heath J, Hahn E, et al. Impact of Smokeless Tobacco Products on Cardiovascular Disease: Implications for Policy, Prevention, and Treatment: A Policy Statement from the American Heart Association. Circulation 2010;122(15):1520–44 [cited 2014 Oct 31].
4. Connolly GN, Richter P, Aleguas A Jr, Pechacek TF, Stanfill SB, Alpert HR. Unintentional Child Poisonings Through Ingestion of Conventional and Novel Tobacco Products. Pediatrics 2010;125(5):896–9 [cited 2014 Oct 31].
5. Lund I, Scheffels J. Smoking and Snus Use Onset: Exploring the Influence of Snus Debut Age on the Risk for Smoking Uptake With Cross-Sectional Survey Data. Nicotine and Tobacco Research 2014;16(6):815–9 [cited 2014 Oct 31].
6. Stanfill SB, Connolly GN, Zhang L, Jia LT, Henningfield JE, Richter P, et al. Global Surveillance of Oral Tobacco Products: Total Nicotine, Unionised Nicotine and Tobacco-Specific N-Nitrosamines. Tobacco Control 2011 May;20(3):e2. doi:10.1136/tc.2010.037465 [cited 2014 Oct 31].
7. California Environmental Protection Agency. Safe Drinking Water and Toxic Enforcement Act of 1986: Chemicals Known to the State to Cause Cancer or Reproductive Toxicity (May 2, 2014)..[PDF–403 KB] California Environmental Protection Agency, Office of Environmental Health Hazard Assessment [accessed 2014 Oct 31].